کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
2982793 1578681 2008 7 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
The role of temporary biventricular pacing in the cardiac surgical patient with severely reduced left ventricular systolic function
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی کاردیولوژی و پزشکی قلب و عروق
پیش نمایش صفحه اول مقاله
The role of temporary biventricular pacing in the cardiac surgical patient with severely reduced left ventricular systolic function
چکیده انگلیسی

ObjectiveThe objective was to evaluate the effects of atrial synchronous biventricular pacing in postoperative patients with severe cardiomyopathy.MethodsAtrial synchronous biventricular pacing epicardial leads were placed during cardiac surgery in patients with an ejection fraction of 30% or less. Patients were randomized to usual care pacing, the mode determined by the surgeon (excluding atrial synchronous biventricular pacing) with a preference for no pacing or atrial pacing (atrial inhibited pacing); atrial synchronous right ventricular pacing; or atrial synchronous biventricular pacing. Pacing was continued until cessation of hemodynamic support. At 12 hours postoperatively, patients were randomly tested in each mode (atrial inhibited, atrial synchronous right ventricular, and atrial synchronous biventricular pacing), and thermodilution outputs were measured.ResultsForty subjects were randomized. Groups were similar in age (66 ± 11 years), gender (85% were male), ejection fraction (23% ± 6%), QRS duration (111 ± 30 ms), and surgical indication. There was no difference in stroke index or cardiac index at 12 hours, duration of inotropic or intra-aortic balloon pump support, intensive care unit, or hospital length of stay. On comparative crossover testing, stroke volume was similar with atrial inhibited pacing and atrial synchronous biventricular pacing (59.3 ± 13.4 vs 57 ± 12.1, respectively, P = not significant); however, atrial synchronous right ventricular pacing was inferior (56 ± 12.9, P < .05 for comparison with atrial inhibited pacing). When compared with atrial inhibited pacing, atrial synchronous biventricular pacing showed a positive response in 17% of subjects (increase in stroke volume ≥ 5%), whereas 41% had a 5% or greater decrease in stroke volume.ConclusionPacing mode affects stroke volume in patients with severe cardiomyopathy. Atrial synchronous biventricular pacing was helpful in a minority, but in 41% it compromised stroke volume.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: The Journal of Thoracic and Cardiovascular Surgery - Volume 136, Issue 4, October 2008, Pages 915–921
نویسندگان
, , , , , , , , , , , , ,